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Low-dose aspirin does not interfere with the blood pressure-lowering effects of antihypertensive therapy

Alberto Zanchetti1, Lennart Hansson, Gastone Leonetti

  • 1Centro di Fisiologia Clinica e Ipertensione, Università di Milano, Ospedale Maggiore and Istituto Auxologico Italiano, Milano, Italy. zanchett@mailserver.unimi.it

Journal of Hypertension
|May 16, 2002
PubMed

Insights

Low-dose aspirin (ASA) does not affect blood pressure control or kidney function in hypertensive patients, even when combined with angiotensin-converting enzyme (ACE) inhibitors. Cardiovascular benefits of aspirin remain consistent across these treatment groups.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Nephrology

Background:

  • Aspirin (ASA) has been suspected of interfering with antihypertensive medications.
  • Concerns exist regarding potential attenuation of angiotensin-converting enzyme (ACE) inhibitor benefits by ASA in heart failure patients.

Purpose of the Study:

  • To reanalyze data from the Hypertension Optimal Treatment (HOT) Study to assess the effects of low-dose aspirin on blood pressure and renal function in hypertensive patients.
  • To investigate potential interactions between aspirin, antihypertensive agents, and ACE inhibitors.

Main Methods:

  • Reanalysis of data from 18,790 hypertensive patients in the HOT Study, randomized to aspirin (75 mg daily) or placebo for 3.8 years.
  • Examination of effects on systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine, and estimated creatinine clearance.
  • Comparison of cardiovascular event rates and renal dysfunction incidence between aspirin and placebo groups, including subgroups receiving ACE inhibitors.

Main Results:

  • Systolic and diastolic blood pressure control was similar between aspirin-treated and placebo groups.
  • Antihypertensive therapies were comparable in both groups.
  • Changes in renal function markers (serum creatinine, creatinine clearance) and incidence of renal dysfunction were similar.
  • Cardiovascular benefits of aspirin were consistent in patients receiving or not receiving ACE inhibitors.

Conclusions:

  • Long-term, low-dose aspirin does not interfere with blood pressure lowering by antihypertensive agents, including ACE inhibitors.
  • No negative interaction was observed between ACE inhibition and the cardiovascular benefits of low-dose aspirin.
  • Findings do not apply to higher aspirin doses or patients with congestive heart failure.
Abstract

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